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As many of you know, I am an occasional contributor to a British publication called E-Health Insider.

A story published today in EHI’s newsletter for primary care mentioned that a development board for electronic medical records in England is wrestling with what constitutes a “summary record” of patient information in a national database and a “local record” for a patient’s general practitioner.

Hmm, questions over what data elements to put into an EMR? Issues of data ownership and access? Apparently, turf battles and lack of standards in health IT are not a uniquely American problem.

I fired off a long e-mail Thursday night to the listserv of the Association of Health Care Journalists, of which I am a member. I got tired of reading about people discussing why an editor for medical publishing company Elsevier had a hospital deny permission to print a clinical photo of a small portion of an unidentified patient’s body, even though a physician at the same hospital was willing to hand over the image.

Nothing in healthcare frosts my biscuits more than HIPAA-related paranoia.

This is how I responded:

Yes. there is a lot of paranoia about HIPAA, mostly because it’s badly misunderstood. For example, HHS has said it is perfectly fine for staff to call out patient names in waiting rooms. Click this link to go to the HHS privacy FAQ page and click on Subject #5.

From all the other comments on this listserv, it sounds like the hospital’s refusal to ask for consent had more to do with money (from sale of the rights to such photos) and potential malpractice liability. The potential criminal penalties notwithstanding, I am not aware of the feds prosecuting anybody under the privacy regs to date. The HHS Office for Civil Rights, which enforces the civil part of the privacy regs, has been clear in saying that enforcement will be driven by complaints only. There is no “HIPAA police” out there trying to catch anyone in the act.

One interesting provision in the privacy rules is that covered entities (e.g., hospitals, docs, labs, health plans) have permission share a “limited data set” of de-identified information with public health agencies to identify or respond to a public health outbreak, but news media are expressly excluded from this right. Read it yourself at http://www.hhs.gov/ocr/hipaa/privrulepd.pdf, page 57, final comment at the bottom of the right-hand column and the response that follows on page 58.

The HHS press office is at (202) 690-6343. Someone there should be able to explain the minutiae of the regs. E-mail me directly if you want the name of a HIPAA consultant or lawyer.

I took the trouble of carefully researching this information because I think it’s important to explode some of the myths. Whoever is planning next year’s AHCJ meeting, I think this subject might need to be on the agenda.

Here are some interesting tidbits from the annual TEPR conference, which concluded Wednesday:

NextGen Healthcare Information Systems announced a partnership with British clinical decision support developer Isabel Healthcare. Isabel co-founder Jason Maude says that the deal creates the first direct link of diagnostic decision support to an ambulatory EMR product.Maude started the company with Joseph Britto, M.D., who was the attending physician when a misdiagnosis by a resident at a London hospital nearly took the life of Maude’s daughter, Isabel, at age 3. I wrote about Isabel Healthcare a couple of years back when I was on staff at a certain magazine that’s now dying a slow, painful death.

Allscripts Healthcare Solutions is publishing a book entitled The Electronic Physician: Guidelines for Implementing a Paperless Practice. Allscripts product management VP Stuart Scholly calls it a collection of best practices for EMR implementation compiled from company experts and customers.Allscripts itself, and not any specific individual, gets the author credit, though Scholly says the book does not even mention the company after the first chapter, so as not to have others take it as a sales tool.

The book should be available on Amazon within a couple of weeks. It lists for $29.95, or $41.95 if you’ve got Canadian currency.

SALT LAKE CITY—It’s always a surprise these days when national health information technology coordinator David Brailer, M.D., is not a featured speaker at a conference dealing with electronic health records. But that is exactly what is happening at the annual TEPR conference here this week.

TEPR organizers said that Brailer’s office informed them over the weekend that Brailer had to cancel his planned Tuesday appearance here because the White House called him to some sort of urgent meeting.

The bigger question I want answered is the reason for the White House meeting. Again, making an educated guess, someone in the administration decided that Brailer’s speech was not ready for public consumption. I believe—though I could be wrong—that Brailer was to begin laying out an action plan based on last winter’s public request for information.

Free Healthcare IT Newsletter Want to receive the latest news on EMR, Meaningful Use,
ARRA and Healthcare IT sent straight to your email? Get all the latest Health IT updates from Neil Versel for FREE!

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